Case Study: Medical Coding for a California Billing Company

Overview

OSI (Outsource Strategies International), an MOS company, offers medical coding services for various medical specialties. We were approached by a medical billing company based in LA, California in September 2012. The company provides medical billing for specialties such as pain management, cardiology and internal medicine all over the nation and helps healthcare professionals and organizations improve their efficiency. They have in-house staff that managed all operations.

The Challenge

The client was experienced in medical billing, revenue cycle management and collections, but did not possess the coding expertise that is absolutely necessary for obtaining maximum reimbursement. So they contacted OSI since we had significant experience in medical coding and could handle many specialties simultaneously.

The Solution

The client chose us primarily because of our broad expertise in various aspects of coding. They relied on our reputation for providing highly accurate and compliant coding. In coding, a correct code will make all the difference in maximum reimbursement so it was critical that they made the right decision in choosing the best partner to work with. We offered a very high quality and cost-effective solution for them. We implemented a team of AAPC-certified coders with extensive experience in the specialties needed, which include Pain Management, Internal Medicine and Cardiology. A project manager was also assigned for managing the process.

The Result

This ongoing project was implemented immediately after the first medical chart was uploaded. All our coding is provided within a 24-hour turnaround time. For billing purposes we provide CPT, ICD-9 and the associated modifiers. We also offer guidance when medical documentation is absent in the chart, and crosswalk codes depending on the billed insurances. OSI’s AAPC-certified coders have the required expertise in commercial and federal coding guidelines.

The client is very happy with our services. Only after reviewing our coding did they realize that there were many providers who were under-coding procedures. In many cases the documentation provided allowed us to code a higher specificity to ensure higher reimbursement. OSI is looking forward to working with this client for many more years to come.